Washington Post columnist Jennifer Rubin used the Gosnell trial to suggest several ways to further diminish access to safe, legal abortion care in the United States through what she calls a "Gosnell amendment." She has no idea what she is talking about.

There are two roles anti-choicers like to play for which they are ill-equipped. First, they like to play doctor. And second, they like to play God. In doing so, they spread outright lies about both abortion and contraception to mislead and whip the public into a frenzy about sex, pregnancy, and childbirth. And then, believing themselves to be the righteous ones, they seek to capitalize on their self-created panics to make public health and medical policy for the country based solely on emotion, facts be damned. Their end goal, as they make clear, is to outlaw abortion and contraception no matter the costs to public health, women’s lives, or society writ large.

The trial of Kermit Gosnell provides anti-choicers and their allies with a perfect platform for their efforts. In Gosnell, they have an unethical, unscrupulous criminal acting as a doctor. He preyed on women too poor to seek early, safe abortion care, ran a filthy “clinic,” and conducted illegal abortions during which, it is alleged, some infants were born alive and killed. In their quest to make safe, legal abortion care as inaccessible as possible, anti-choicers are now seeking to sway public policy by conflating safe abortion care with Gosnell’s atrocities, to tar all legitimate providers of safe abortion care as Gosnell clones, and to use a criminal case as a justification to drive legitimate providers out of business.

One recent example of this effort comes courtesy of Washington Post columnist Jennifer Rubin, who, in a column Wednesday, suggested several ways to further diminish access to safe, legal abortion care in the United States through what she calls a “Gosnell amendment.” If you read the piece, it is clear she has no idea what she is talking about.

Rubin, for example, calls for changes in Medicaid but appears not to understand how Medicaid works in the first place. She also calls for changes in federal funding of abortions, but appears not to understand that current law already severely restricts public funding of abortion.

She writes:

First, all Medicaid and other federal support for abortion services should come with caveats—health standards (of the type Pennsylvania refused to issue and enforce) and appropriate training for all personnel. Second, federal taxpayer dollars should not go for late-term abortions.

Let’s start out by making clear that this is the kind of grasping for irrelevant straws I described above (using the existence of a criminal to tar and feather an entire field of professionals who have no relationship to the criminal activity). For one thing, as confirmed in a phone call today to the Pennsylvania Department of Public Welfare, and notwithstanding the fact that what he did was illegal in the first place so the case illustrates nothing about safe abortion care, Gosnell was not receiving Medicaid payments for women seeking abortion. In fact, in 2010, there were only seven abortions in the entire state of Pennsylvania paid for by state tax funds, and no federally funded abortions anywhere in the state that year. As in zero. Zip.

But no mind: Rubin claims that Gosnell proves there are problems with federal Medicaid funding of abortion care, because eliminating Medicaid funding of abortions for any low-income woman under any circumstance is high on the anti-choice agenda and Gosnell gives them a platform for their arguments.

As for regulations and “health standards,” both the Centers for Medicaid and Medicare Services and state Medicaid agencies already work together both to certify and regulate Medicaid providers of all kinds, and both medical societies and advisory boards at the state and federal level set standards for care. Does this mean there is never any fraud? Of course not: Republican Rick Scott, the current governor of Florida, was implicated in one of the biggest Medicare frauds in the country in the late ’90s, showing that laws on the books are in fact broken until evidence is accumulated to bring a case. It was not lack of law or regulation, but rather lack of enforcement that allowed Gosnell to carry on for so long. Changes to Medicaid would therefore not have prevented and will not prevent past, current, or future quacks or criminals from operating in such a capacity until they are caught, just as homicide laws will never prevent all homicides and laws against arson won’t eliminate arsonists. Laws and regulations are meant both to define and to hopefully reduce criminal activity but will never eliminate it.

Rubin’s suggestion that federal taxpayer dollars should not go for abortions also is a head-scratcher, since the Hyde Amendment already forbids the use of federal funds for abortions except in cases of life endangerment, rape, or incest. This law has guided public funding for abortions for low-income women under joint federal and state programs since 1977. At a minimum, states must cover those abortions that meet the federal exceptions. States also are free to expand coverage of Medicaid funding of abortion for other reasons, using their own funds. Pennsylvania does not offer expanded Medicaid coverage for abortion.

Moreover, the system in Pennsylvania (as in many states) is such that even in cases of rape and incest it is virtually impossible to get reimbursed for a Medicaid-eligible abortion. As Claire Keyes, former director of a clinic in Pennsylvania, told RH Reality Check via email:

Although technically Medicaid in PA is supposed to cover rape and incest, in reality it did not. There were too many sub-carriers, if that is the right word, each with its own rules, own personnel. No matter how much time we as providers tried to “train” their employees for them in order that women whose pregnancies resulted from rape or incest would be covered, it was not worth it. No one from the top level of management ever cared enough to issue policy statements to their employees, so it was just a waste of time. We often had to submit 4-5 times for the same patient, then reaching the end of the eligible period for submission for reimbursement of the services. It was easier to not even try.

If one takes Rubin at her word, she would like to eliminate the exception in the Hyde amendment for Medicaid coverage for any “late-term” abortions, though she does not specify what she means by “late-term.” In the third trimester only, or both second and third trimesters? Is she saying that there should be no public funding whatsoever to cover an abortion for a poor woman whose life is quite literally in danger from a pregnancy gone terribly wrong? And if so, is she not then saying that the life of a woman living in poverty has less value than the life of a woman with a similar condition who can afford an abortion on her own? Does she mean to imply that a woman in the United States facing a situation similar to one now going on in El Salvador—where a woman now carrying a non-viable fetus and whose kidneys are failing due to pregnancy-related complications of uncontrolled lupus—should be left to die?

That gets us to the broader issue of late-term abortions. Every state should have an infant-born-alive statute, and those states that do not should have to justify why medical personnel should not have an affirmative duty to provide medical care to an infant who survives abortion. Do we really want any state to endorse by silence Gosnell’s practices?

Perhaps Jennifer Rubin was out of the country or not reading the papers in 2002 when President Bush signed into law the Born-Alive Infant Protection Act. This is federal law, as in it covers all the states. Since Kermit Gosnell is and was a criminal, he was not adhering to the law, as is the nature of the term “criminal.”

And exactly how far does Rubin want to go to eliminate late abortions? Under Roe v. Wade, states may not prohibit abortions even after fetal viability in cases where it is “necessary to preserve the life or health” of the woman. Third-trimester abortions, which make up an estimated 1.3 percent of abortions in the United States, happen when there are medical complications that compromise the life or health of the woman in question or fetal anomalies incompatible with life. In the Gosnell case, women who came for late abortions came for them because they didn’t have enough money to get early abortions, conditions created by the very policies Rubin advocates.

If she wants a total ban on late abortions without exceptions for life and health, which women does Ms. Rubin suggest should be left to die? Which women should be left with lifelong health problems from a pregnancy gone horribly wrong? It’s a little harder when you have to face real people in need, so I ask, for which of these women does Rubin feel she or others are better equipped to decide what to do? Would she make the choice for Kate? For Gracie’s parents? For Autumn Elise’s parents? Why does Rubin or anyone else get to decide for these families what is best for them?

The inconvenient truth here is that the very policies anti-choicers espouse are the ones that create the conditions in which Gosnells thrive: limiting access to safe abortion care by closing clinics, driving up the costs, requiring women to go through innumerable unnecessary hoops to secure an abortion, and driving them later in the process—denying women living in poverty public support for safe abortion care. All of these and other policies espoused by anti-choicers drive women to desperate circumstances, as a trip to any number of countries with high rates of maternal mortality from complications of unsafe abortion will tell you.

Rubin’s column doesn’t prove any of the points she apparently set out to make, but it does prove a few things: She isn’t cut out to play doctor, God, or legislator. And given the inexcusable lack of factual accuracy in her piece, it is not clear to me she is cut out to be a columnist either. I know that the Washington Post got rid of its ombudsperson, but did it fire all the editors and fact-checkers too?

As immigrant women continue to seek better lives in the United States—51 percent of new immigrants are women—we cannot neglect the impact health-care policies and anti-choice legislation have on their lives.

Karnamaya Mongar, a Nepalese woman and mother of three, immigrated to the United States in July of 2009 after losing a 4-year-old daughter to cholera and spending 20 years of her life in a refugee camp. She became pregnant just as she arrived to this country and felt her family was not ready for another child, saying, “We just got started here.”

Just four months after her arrival in the United States, Mongar’s 4-foot-11, 110-pound body lay dead at the clinic of Dr. Kermit Gosnell in an impoverished Philadelphia neighborhood.

Today, the trial of Dr. Kermit Gosnell, whose medical staff was responsible for overdosing Mongar with the drug Demerol, is making headlines. Among other charges, Gosnell is charged with third-degree murder for the death of Mongar. He could be sentenced to death if found guilty. Much of the trial coverage has focused on Gosnell and the deplorable conditions in which his facilities were kept. Less attention has been paid to the lived experiences of immigrant women trying to plan their families, or to the larger political and legal environment that creates fertile ground for the likes of Gosnell.

And so, I would like to remember, honor, and shed light on Mongar’s story and the reasons she ended up in Gosnell’s house of horrors.

Mongar’s experience exposes the many barriers to health immigrant women face, as well as the horrific side effects of anti-choice policies.She and her family were among thousands of people expelled from their homeland of Bhutan following pro-democracy protests and were part of a humanitarian resettlement program. Her husband had just found a job in a chicken factory in Virginia where they lived. When she learned she was pregnant, Mongar sought to have an abortion in her home state of Virginia. However, 85 percent of Virginia counties did not have an abortion provider at all. Making matters worse, at 19 weeks pregnant Mongar was in her second trimester, after which Virginia legislation made it illegal for clinics (but not hospitals) to administer abortions.

Frustrated after being unable to find a provider in Virginia or Washington, D.C., that would serve her, Mongar went to Philadelphia to see Dr. Gosnell, who was known for performing cheap abortions regardless of gestational age. Mongar had no idea she would never return home. She did not speak English, was made to sign documents that were not translated for her, and was not given the pre-op counseling required by state law. Her clinic experience was unsanitary and dangerous; investigators discovered fetuses in the clinic’s toilet and stored in jars, and medical staff were untrained and included a 15-year-old high school student who administered anesthesia.

Gosnell’s clinic thrived because of legal and funding restrictions on abortion. Victims were predominantly immigrant women, low-income women, and women of color who had little access to information and financial resources. In addition to Mongar, another woman died at Gosnell’s clinic in 2000 from a perforated uterus, and many more suffered from perforated bowels and cervixes. Some women were even made sterile.

Keeping abortion services legal, physically accessible, and affordable can help prevent horror stories like Mongar’s. If Virginia legislation allowed clinics to perform second-trimester abortions and if safe abortion providers were affordable and more numerous throughout the state, perhaps Karnamaya Mongar would be alive today. Keeping abortion legal and making it accessible means women’s health and safety will be ensured. Studies have shown that restricting abortion does not mean women will not find a way to get an abortion. Moreover, the Hyde Amendment, which bans Medicaid funding of abortion, gives poor women very few safe options. Faced with an unwanted pregnancy and limited financial resources, many women are forced to risk their health and, in some cases, their lives.

As immigrant women continue to seek better lives in the United States—currently 51 percent of immigrants in the United States are women—we cannot neglect the impact health-care policies and anti-choice legislation have on their lives. This is why, at the National Asian Pacific American Women’s Forum, I work to ensure abortion care is affordable and advocate for health care for immigrant women. Immigrant women deserve safe, affordable reproductive health services—not a house of horrors.

Abortion providers and the women they serve are already feeling the sting of anti-choice legislators all too eager to use the Gosnell case as a flimsy excuse for rolling back reproductive rights and access.

The details seem so outrageous that at first glance you assume they cannot be true. Fifteen-year-olds assisting in abortion procedures. Unsterilized equipment and blood splattered everywhere. Third trimester fetuses delivered and then killed by slicing their spinal cords. But that was the hard reality of Women’s Medical Society, an unassuming clinic in West Philadelphia that for decades operated with little inspection or oversight. The clinic’s now infamous doctor, Kermit Gosnell, is being formally charged with the deaths of one woman and seven infants, but the grand jury report concluded that the death toll of his clinic was likely higher.

Major news outlets have only recently begun to cover Kermit Gosnell’s murder trial, but coverage has focused on the sordid details of Gosnell’s clinic. What’s missing from the headlines is the legacy of the Gosnell case. In Pennsylvania, abortion providers and the women they serve are already feeling the sting of anti-choice legislators all too eager to use the Gosnell case as a flimsy excuse for rolling back reproductive rights and access even further in the state. And it’s only a matter of time until another state invokes Kermit Gosnell’s name in defense of yet another piece of anti-choice legislation.

“All health care providers must be regulated, and these regulations should be based on health care needs—not on politics,” Dayle Steinberg, president and CEO of Planned Parenthood Southeastern Pennsylvania, said in a statement. Abortion providers, like other health-care providers, already are regulated. Abortion clinics and providers already comply with a host of regulations and oversight mechanisms. As Tara Murtha of the Philadelphia Weeklypoints out, “Those with labs on site—most do [have labs]—must be inspected under the federal Clinical Laboratories Improvement Amendments. Abortion providers performing 100 or more procedures a year must be registered with Patient Safety Authority and comply with MCARE Act, which requires inspections. Abortions in Pennsylvania can only be performed by licensed physicians, regulated by the state’s Board of Medicine.”

None of this mattered to Gosnell. Ask any provider or advocate in Pennsylvania and they’ll tell you: He was a rogue agent operating outside the law and far beyond any sort of ethical code. But even after reports of shockingly unsanitary conditions and multiple deaths, attempts to shut down the clinic were routinely thwarted by massive bureaucracy and simple disinterest in pursuing the case.

The problem wasn’t a lack of regulations, it was a failure to check on Gosnell’s clinic to make sure they were actually following the safeguards on the books.

Despite this, the “discovery” of Women’s Medical Society was the impetus for the passage of Act 122 in 2011. The bill, which the Women’s Law Project of Pennsylvania calls the National Right to Life Committee’s “wish list” of abortion regulations, classified abortion clinics as ambulatory surgical facilities. “Gosnell was the driving force in the debate over [the targeted regulation of abortion providers (TRAP) legislation],” said Andrew Hoover, legislative director of the American Civil Liberties Union of Pennsylvania. The bills were already being debated when his clinic was raided, but the “discovery” of Gosnell’s clinic added to the swiftness with which legislators debated the bills—and the lack of in-depth scrutiny of the proposed restrictions.

Indeed, the specter of Gosnell was raised again and again during debate of SB 732 (what would become Act 122) and HB 574, the state house version of the same regulations. “This is about patient safety and preventing future cases of murder and infanticide within abortion clinics,” state Rep. Matt Baker (R-Bradford/Tioga), chair of the House Health Committee, said in a statement in 2011.

“In the end this is about the protection, yes, the protection of women and innocent unborn and innocent born children in response to the Gosnell situation. The language amended is a reflection of the care and safety to all individuals, given the tragedies that occurred for almost four decades at that particular facility,” echoed state Rep. Mike Turzai (R-Allegheny).

Floor debates suggested that supporters of the regulations either didn’t know that abortion facilities were regulated, or conveniently ignored that fact. Rep. Baker argued that “the template for this legislation … is the grand jury report.” However, it should be noted the grant jury report did not recommend regulating abortion clinics as ambulatory surgical facilities. Nowhere in supporters’ commentary was an acknowledgement of the strong safety records and compliance rates of the other reputable facilities in the state.

Yet Act 122 passed, forcing Pennsylvania’s clinics to adhere to many of the architectural and staffing regulations of ambulatory surgical facilities. Health centers had to make many unnecessary changes that had little impact on women’s health.

The renovations rattled the pro-choice community in Pennsylvania by forcing clinics to shut down, some of them temporarily, and divert staff and financial resources to making sense of somewhat complicated and dense architectural regulations. The burden is ongoing. “Unfortunately the process of compliance, which has involved weekly conversations and frequent, interruptive inspections with the Department of Health, takes an astronomical amount of both staff time and clinic funds that it diverts our efforts away from growing our center in ways that will better serve our community,” said Jen Boulanger, director of communications for the Women’s Centers, which operates clinics in Philadelphia and Cherry Hill, New Jersey. She estimates that the group has spent hundreds of thousands of dollars on the changes for their Philadelphia clinic.

But some clinics never re-opened their doors, and others had to limit their practices to first trimester procedures under local anesthetic, according to Boulanger. The Women’s Law Project of Pennsylvania points out that before Act 122 passed, there were 22 legitimate, safe clinics operating in Pennsylvania. Today, there are just 13. Will that number continue to drop?

Many media outlets seem to care less about that question; they’d rather focus on a play-by-play of Gosnell’s “house of horrors.” But we should be thinking about how anti-choice forces used the Gosnell case to ram through Act 122 in Pennsylvania, and how it devastated Pennsylvania’s already-tenuous network of reproductive health resources, because make no mistake: anti-choicers in other states are taking note and following in lockstep.

The Hillsuggests that there will not be any Congressional action on abortion in the wake of the Gosnell case, but that doesn’t stop Congress from attacking its favorite punching bag, the District of Columbia. Rep. Trent Franks (R-AZ) has already re-introduced a bill to outlaw abortions in D.C. after 20 weeks to capture the momentum from the Gosnell case. (“Sanitizing the clinic” by adding regulations and restrictions won’t solve the problem, he says.)

Anti-choice legislators in the states could very well seize the Gosnell case as an opportunity. As RH Reality Checkreported last week, legislators in Utah and Virginia are capitalizing on the Gosnell case to build support for more stringent clinic regulations. Elissa Berger, advocacy and policy council for the American Civil Liberties Union (ACLU), notes that ACLU state affiliates are continuing to fight an onslaught of anti-choice legislation, a trend she says will continue regardless of the outcome of the trial.

But she points out that this legislation isn’t about keeping women safe, despite what legislators may claim. “The issues raised in the Gosnell trial are not about safe, legal abortion care,” she said. “But that’s what they’re legislating. It’s hard to imagine being in a climate where worse things could come down the pike [after the Gosnell trial] … it’s clear we’ll have to continue to fight very hard.” And, as more and more safe, reputable providers close their doors, women will go to whatever provider they can find, with potentially devastating consequences.

Yes, the media has largely dropped the ball on the nuances of this case, when they’ve bothered to cover it at all. Yes, issues of racial and socioeconomic disparity are being grossly neglected (though, happily, they are being championed by many feminist and progressive blogs and publications, including this one).

But while we’re debating who is covering what and how, we’re ignoring a growing movement by anti-choice forces to twist a case of plain and simple negligence into a call for rolling back abortion rights altogether. But the more we restrict access to reproductive health, the more opportunities we provide criminals like Gosnell to flourish and fester.

Of course, it’s not as if the legislation wasn’t in the works already; TRAP regulations on the state level are not a new phenomenon. But now, the horrific, grisly details of the Gosnell case provide the perfect exhibit A for why abortion providers should be regulated out of existence. Pennsylvania is a textbook example. But make no mistake: Pennsylvania will not be the only one.

Tennessee Republican Rep. Marsha Blackburn has been on the attack against the nation’s largest provider of reproductive health care services since the moment the 2013 Congressional session began. By January 9th she had already introduced a bill to de-fund Planned Parenthood nationally, despite the fact it was highly unlikely such a law would ever be approved by the Senate or signed by the President, nor would it be supported by the majority of voters.

Now Blackburn is joining the chorus of far right anti-choice, anti-birth control politicians that have been using their congressional influence to bring what they believe has been a lack of media coverage to the trial of Kermit Gosnell, a Philadelphia doctor accused of performing illegal, unsanitary, and unsafe abortions sought primarily by women living in poverty. But unlike her cohorts Rep. Chris Smith or Sen. Marco Rubio, Blackburn is going a step further and trying to tie Gosnell into her vendetta against Planned Parenthood.

“The broadcasters’ blackout of the Planned Parenthood infanticide lobbying scandal and the Gosnell ‘House of Horrors’ murder trial are the biggest and most politically-motivated media cover-ups in our nation’s history,” Blackburn stated via press release. “Censorship and media bias allows the corrupt abortion industry to profit at the expense of innocent women and children. The mainstream media has a responsibility to report the truth, not turn a blind eye to the biggest civil rights issue of our time.”

The “Planned Parenthood infanticide” faux-scandal Blackburn evokes refers to a debate on the floor for a recent bill in Florida where the legislature proposed “aid” to any fetus “born alive after a botched abortion.” According to bill proponents, who cited stories from the 80’s and 90’s of failed saline abortions or babies allowed to gasp for breath and be ignored post termination, a bill for infant protection is necessary despite legislators admitting they had no evidence that such a thing actually occurs at all. When a representative from Planned Parenthood testified that “We believe any decision that’s made should be up to the woman, her family and the physician,” anti-choice lawmakers and activists ran with the statement to claim that the group advocates “post-birth infanticide.”

The claim is more than disingenuous. After all, the current governor of Florida once ran a hospital that provided extensive, invasive treatment to an infant on the edge of viability against her parents’ expressed wishes. When the child then survived and had numerous medical conditions and required constant and expensive medical attention, Scott’s hospital refused to pay for the child’s care despite overriding the family’s medical decisions. Scott then cited the full incident as proof of his “pro-life” credentials.

That the anti-choice movement misrepresented the witness’s testimony in an attempt to create a media backlash at Planned Parenthood is little surprise. That Blackburn and her cohorts would try to do it again so soon with the Gosnell trial is probably just as expected. On April 11, Rep. Chris Smith and nine other House members took to an empty floor to give speeches condemning the media for “ignoring” the Gosnell trial. During the speeches many of the politicians claimed to speak for the “unborn” and demand an end to abortion while decrying the alleged media blackout. Rep. Blackburn’s move to take it one step further and tie the two together is just the latest in a right-wing agenda to play the media and place every narrative into their own frame. And in that frame, they want to eliminate Planned Parenthood, which if successful, would of course just lead to more women dying.

Less than two hours after bombings tore through Monday’s Boston Marathon, Jennifer Rubin, who writes the Right Turn column for the Washington Post, tweeted an anti-choice potshot about the trial of Kermit Gosnell, a provider of illegal abortions.

That language—”a local crime story”—is a direct reference to Rubin’s colleague, Washington Post reporter Sarah Kliff, who has been widely criticized by conservatives and anti-choicers for not covering the Gosnell story. When confronted on Twitter about not covering the story on April 11, Kliff said that she had not covered Gosnell because “I cover policy for the Washington Post, not local crime.” As Amanda Marcotte noted at Slate, “It was exactly the wrong response. … By Friday morning Kliff’s tweet was prima facie evidence for conservatives that the media was spiking the story.”

Two hours after Rubin sent that tweet, and four hours after the bombings, Rubin tweeted an agreement with conservative blogger Erick Erickson that the day was not one for beating up on President Obama. At the time of publishing she has not responded to an inquiry about why she feels attacks on President Obama are an inappropriate response to the Boston bombing, but using the tragedy to lob anti-choice potshots at a colleague about the Gosnell trial is acceptable.

In recent days, amidst cries of a media “blackout,” a number of journalists have admitted to either missing or dismissing the story of Dr. Kermit Gosnell over the past two years. As one of the many journalists who has been covering the Gosnell story since it broke in early 2011, all I can say is: We tried to get the story out there. But more importantly, this politics-of-media framework distracts from the circuitous politics that enabled, and resulted from, Gosnell’s actual crimes and the women who were affected.

What Media Blackout?

After spending much of 2010 interviewing 58 witnesses, in January 2011 the Philadelphia district attorney’s office published a 281-page report accusing Kermit Gosnell of grotesque, depraved crimes.

There was blood on the floor. A stench of urine filled the air. A flea-infested cat was wandering through the facility, and there were cat feces on the stairs. Semi-conscious women scheduled for abortions were moaning in the waiting room or the recovery room, where they sat on dirty recliners covered with bloodstained blankets. All the women had been sedated by unlicensed staff—long before Gosnell arrived at the clinic—and staff members could not accurately state what medications or dosages they had administered to the waiting patients. Many of the medications in inventory were past their expiration dates.

Fetal remains were stored in milk jugs and cat food containers. A janitor admitted he routinely pulled fetal parts out of pipes. Unlicensed, untrained staff, including a high school student, pumped cheap, powerful drugs into the veins of women who were chemically coaxed into zombie-like stupors that sometimes lasted days.

Last week, Kristen Powers published an op-ed in USA Today that sparked a Twitter shame campaign, directly asking prominent national journalists why they hadn’t covered the case. And it worked. Now, more than three years after the raid and more than two years after the grand jury report, some national journalists who ignored the case entirely are suddenly wildly interested.

After years of coverage from outlets in Philadelphia and Harrisburg, outlets focused on women’s health issues, and yes, mainstream media outlets, apparently all it took to catch the attention of writers such as Slate’s Dave Weigel, The Atlantic’s Conor Friedersdorf, and Jeffrey Goldberg of Bloomberg was to target their collective egos—specifically, their insecurity about being perceived as having a liberal bias.

Weigel, one of the first writers to develop a sudden interest in Gosnell after Powers’ piece, wrote that when he read about Gosnell back in 2011, he didn’t “see a political story to chase.”

At 3801 Lancaster, the site of Gosnell’s clinic, patients chose their medicine and painkillers a la carte. In other words, the more cash a patient could give Gosnell, the more painkiller she could get. The poorer the patient, the more she would suffer. With all the talk about the Affordable Care Act, you’d think that such starkly stratified access to quality health care would be an interesting political story. The story touches on poverty, abortion, civil rights, state rights, healthcare, increasing inequality and race, to name a few topics of political interest that, if nothing else, came up quite a bit during the presidential election.

What Weigel really meant, of course, is that he didn’t see a story worth chasing. “Bored media,” indeed.

It’s telling that Weigel, whose original post characterized Slate writer William Saletan as something of a brave lone soul breaking the media silence around the case, had to issue a correction clarifying that actually, Slate writer Amanda Marcotte also wrote about the case—almost a month before Saletan. He just didn’t notice.

I would be more convinced of a left-wing media blackout if the story of an alleged drug trafficker who was allowed to maim and murder women for years because of serious oversight failures wasn’t dismissed as a “women’s issue,” written about mostly by female reporters and apparently not well read by male journalists.

In any case, the journalists who missed the story are not victims of a liberal media conspiracy, and neither are the conservatives leading the recent media campaign. From the very beginning, the right viewed the Kermit Gosnell trial as a tremendous media opportunity.

In the spring of 2011, anti-choice group Operation Rescue traveled to Pennsylvania to hold a meeting in a church basement in the suburbs of Philadelphia. It was a pilgrimage.

“Philadelphia is in many ways similar to the Alamo,” Operation Rescue President Troy Newman told the small crowd of mostly elderly citizens, as reported in the Philadelphia Weekly. “You’re here, this is your moment. … God handed you an opportunity for success. For victory.” (It was apparently lost on the crowd of suburban churchgoers that they were being asked to gather intel on local doctors for an organization linked to the murder of at least one.)

Newman didn’t bother with spin when talking among friends. “[Young reporters] are not the old-school bra-burning feminists,” Newman said. “The majority of them are pro-life. It’s just the old hardened producers now that we’ve got to just wait for them to fall off the apple cart.”

Manipulating the media is made easier by targeting journalists who are more concerned with hiding their own blind spots and biases than pursuing the truth. While I welcome more journalists taking a look at the Gosnell case, it would be helpful if they would begin by reading the grand jury report that’s now been online for 27 months. If they read it, they wouldn’t be pounding the table, asking, How could Kermit Gosnell have happened?

From the report: “[In 1993] the Pennsylvania Department of Health abruptly decided, for political reasons, to stop inspecting abortion clinics at all.”

Political Causes and Implications

In 1989, Democratic Pennsylvania Gov. Bob Casey signed the landmark Abortion Control Act (ACA) into law. The ACA established, for the first time, that states could pass restrictions on access to services, though Roe still ensured that states couldn’t outlaw abortion outright. Pennsylvania’s ACA is the blueprint for state-level restrictions to abortion access across the country. After that, abortion had become so politicized that the next governor, pro-choice Republican Tom Ridge, made the woefully misguided decision to not address abortion altogether.

Fast forward to December 2011, when Pennsylvania Gov. Tom Corbett signed into law a bill that, as it was designed to do, shut down some abortion clinics in the state. Over-regulating clinics out of business is an old strategy that advocates say conservative Pennsylvania legislators have been wanting to pass for years, and they finally got it done by lying to the public, claiming the bill was proposed in response to Gosnell. Since the new regulations took effect, Pennsylvania has gone from having 19 clinics that offer surgical abortion—and pap smears, and birth control, and education—down to only 13, as of January.

So this sudden burst of interest in the Gosnell case and shaking of fists comes too late for Pennsylvania women. Meanwhile, Gosnell’s name is still being invoked to help pass similar laws around the country. “There was a widely felt impact,” Elizabeth Nash, state issues manager at the Guttmacher Institute, told RH Reality Check. “The Gosnell case was being used in Utah to change their clinic regulations. It was being brought up in Virginia surrounding their clinic regulations.”

Gosnell is the result of politicizing women’s health care, and his case, in turn, has been used to further politicize women’s health care. Real information about the effect of shutting down abortion clinics—preventable injury, illness, and death, not to mention forced births, all of which happened at Gosnell’s clinic—has been squeezed out of the conversation.

It makes awful sense that the Gosnell case happened in Pennsylvania, where state-level restrictions were established by former Gov. Casey. Notice how a post-Casey world is starting to look a lot like a pre-Roe one. When women don’t have access to safe health care and abortion services, enterprising capitalists like Gosnell start to pop up and women live by the rule: The less money you have, the more you will suffer.

Editor’s note: This article, being republished in April 2013, was originally published by RH Reality Check in 2011 when the details about illegal abortions performed by Dr. Kermit Gosnell first became clear.

Reading the Grand Jury report on Women’s Medical Society in Philadelphia, the now-closed abortion clinic ran by Dr. Kermit Gosnell, is stomach turning. This was truly a chamber of horrors: a filthy facility, with blood stained blankets and furniture, unsterilized instruments, and cat feces left unattended. Most seriously, there was a jaw dropping disregard of both the law and prevailing standards of medical care. Untrained personnel undertook complex medical procedures, such as the administration of anesthesia, and the doctor in question repeatedly performed illegal (post-viability) abortions, by a unique and ghastly method of delivering live babies and then severing their spinal cord. Two women have died at this facility and numerous others have been injured. What remains baffling is how long this clinic was allowed to operate, in spite of numerous complaints made over the years to city and state agencies, and numerous malpractice suits against Dr. Gosnell. Indeed, it was only because authorities raided the clinic due to suspicion of lax practices involving prescription drugs that the conditions facing abortion patients came to law enforcement’s attention.

As information about this clinic spread, many have understandably compared Women’s Medical Society to the notorious “back alley” facilities of the pre-Roe era, when unscrupulous and often unskilled persons (some trained physicians, some not) provided abortions to desperate women, in substandard conditions. This is an apt comparison. But Gosnell’s clinic should not only be understood as a strange throwback to the past. Women’s Medical Society represents to me an extreme version of what I have termed “rogue clinics,” facilities that today prey on women, disproportionately women of color and often immigrants, in low income communities.

“that such clinics can flourish until the inevitable disaster occurs…is a ‘perfect storm’ caused by the marginalization of abortion care from mainstream medicine, the lack of universal health care in the United States, and the particular difficulties facing undocumented immigrants in obtaining health care.”

All these factors helped explain why women came to Gosnell’s clinic, in spite of its location in Philadelphia, a city with several reputable abortion facilities. Among the saddest things I have read in the wake of this disaster is the account of a Philadelphia social worker, pointing out that the community health center which serves the same low- income neighborhood in which the Gosnell clinic was located is considered to be one of the city’s best facilities. But as a recipient of federal funding, of course this center could not offer abortion care.

So why did Gosnell’s patients not go to a better, i.e. safer, abortion clinic, for example, the Planned Parenthood in downtown Philadelphia, no more than a few miles from Women’s Medical Society? One very poignant answer to this comes from a statement that one of Gosnell’s patients made to the Associated Press. The woman had initially gone to this Planned Parenthood for a scheduled abortion, but “the picketers out there, they scared me half to death.”

Another reason women came to Gosnell’s clinic is that he undercut everyone else’s prices. As numerous abortion clinic managers have told me over the years, for very poor women—who are way over-represented among abortion patients—differences of even five or ten dollars can be the deciding factor of where to go. The price list at Women’s Medical Society, listed in the Grand jury report, shows that in 2005, a first trimester procedure was $330.00, while the average price nationally then was about one hundred dollars higher. For a 23-24 week procedure, Gosnell charged $1625.00, while the relatively few other facilities in the Northeast offering such abortions would have charged at least one thousand more.

Still another reason drawing women to this clinic was that it became widely known that Gosnell was willing to flout the law and perform post-viability (i.e. post-24 week) abortions even in cases where women did not meet the very strict legal guidelines of a life-threatening or serious illness or were carrying a fetus with a lethal anomaly. In a horribly unfair vicious cycle, the poorest women often take time to raise the funds for an abortion, and then find themselves past the cutoff for procedures available early on–and facing a higher cost for an abortion. When women in these situations realize that they neither have the funds to pay for a later procedure, and/or can’t find a reputable provider that will perform their procedures after 24 weeks, they end up at places like Women’s Medical Society.

Predictably, in response to the story of Dr. Gosnell’s clinic, the antiabortion movement has been calling for additional massive oversight of all clinics, and claiming that all abortion providers resemble this outlier. But the overwhelming majority of abortion-providing facilities in the U.S. are not rogue clinics and legal abortion has achieved a remarkable safety record, the aberration of Gosnell-like providers notwithstanding. According to the Guttmacher Institute, the death rate from abortion performed in the first eight weeks of pregnancy is one in one million. The right lesson to be drawn from this tragic story is that there will be more unnecessary deaths among the most vulnerable women in our society until affordable and accessible abortion is made part of mainstream medicine.

Unable to muster actual compassion for Gosnell’s victims, anti-choicers got right to work seeking ways to exploit his crimes to further reduce access to safe, legal abortion, and to create more Gosnells in the future.

Kermit Gosnell, the sadistic monster who exploited lack of access to safe abortion care among poor and immigrant women to both torture women and kill actual babies, is finally on trial and anti-choicers are having a feeding frenzy. Unable to muster actual compassion for Gosnell’s victims, anti-choicers got right to work seeking ways to exploit his crimes to further reduce access to safe, legal abortion—and to create more Gosnells in the future. In order to achieve the goal of driving more women to monsters like Gosnell and away from safe, legal clinics, anti-choicers are telling more lies than usual. (Which hardly seemed possible, but once you wind them up, they can really get going.) I don’t usually feel comfortable speaking for pro-choicers as a whole, but in this case, I believe we’re all on the same page, so I thought I’d use this space to get the facts straight.

So here is a list of the facts about how pro-choicers are reacting to the Gosnell case. Anyone who denies these facts is lying, and you have to ask yourself why they feel the need to lie to make their case.

Pro-choicers condemn Kermit Gosnell and hope that he sees justice. When the story broke, there was a rush of feminist journalists who covered the case and the tone was universal condemnation and advice on how to prevent such crimes in the future. A quick search of RH Reality Check demonstrates that, and youcan readother feministtakes around the internet. For people who aren’t trying to prop up lies to confuse the situation, this universal pro-choice condemnation of Gosnell was entirely predictable. Not only do we believe he is a murderer and likely a sadist, but we believe he exploited the desperation of low-income women who need abortions but struggle to afford quality care. We agree with the prosecutors who wrote that Gosnell “ran a criminal enterprise, motivated by greed.” As advocates of quality health care for women, we have tried, sadly in vain much of the time, to remind people who simple fixes, such as offering Medicaid coverage of abortion, could take the issue of cost off the table and make it easier for women not to resort to illegal operators who use unsanitary and sadistic methods, like Gosnell.

Pro-choicers are the ones trying to prevent future Gosnells. Gosnell made money exploiting desperate women, so the way to prevent future monsters like him is to make sure women aren’t desperate. Pro-choicers raise money for abortion funds, so more women can afford quality care. They set up volunteer-staffed help lines to get women through the process of seeing a reputable provider. They demand an end to the Hyde Amendment, so low-income women can use Medicaid to pay for quality providers. As pro-choice blogger PZ Myers wrote, Gosnell “could get by with criminally substandard treatment because our government has been actively destroying the ethical and competent competition.” We try to keep the ethical competition afloat to keep men like Gosnell from getting business. Which should not be conflated, as lying anti-choicers are doing, with trying to stop regulation.

Pro-choicers support holding abortion clinics—and all medical facilities of any type—to a high safety standard. Pro-choicers want women to receive safe, clean, ethical abortion care. We fully and completely support government regulations of all medical facilities aimed at making sure patients get this kind of care. We are so supportive of safe, clean abortion care that we have our own organization called the National Abortion Federation to certify quality clinics. (NAF unsurprisingly refused to certify Gosnell, even though he cleaned his clinic up and pretended to have medically trained staff in an effort to trick them.) The key here is that we believe that abortion clinics should be subject to the regulations like other medical facilities, and that those regulations should be aimed at making sure women get quality care.

Regulations demanded by anti-choicers have nothing to do with securing quality care for women. Quite the opposite: The hope of the endless stream of unnecessary anti-choice regulations in states throughout the country is to shut down quality clinics so women have to go to monsters like Gosnell or resort to putting coat hangers in their uteruses at home. Waiting periods, mandatory ultrasounds, pointless requirements about door size or numbers of closets: All these are there to make it too expensive for lower-income women to get an abortion, so that they resort to desperate measures.

Pro-choicers are furious that Gosnell’s clinic wasn’t inspected for 17 years and complaints about him went ignored. To make it all the more upsetting, one reason inspections were stopped was that there was fear that inspectors couldn’t be trusted to put a priority on women’s health and safety, but instead would use inspections as a pretense to shut down quality clinics. Obviously, Governor Tom Ridge responded incorrectly to anti-choice harassment and abuse of regulatory systems, and pro-choicers condemn his thoughtless response to a delicate situation. But it’s worth pointing out that if regulation of abortion clinics hadn’t been politicized in the first place—if abortion clinics were treated like any other medical facility from the get-go—then none of this would have ever happened. I’m not saying that anti-choicers could have foreseen this particular consequence of their relentless abuse of regulatory systems, but it was one of the many ugly results of their careless disregard for the importance of de-politicizing medical regulations.

These are the facts of the situation. That anti-choicers are denying these facts and making wild claims otherwise can only say one of two things: They either love lying for the fun of it, or they are lying because they can’t make the case based on the facts. I’m guessing the latter. Make no mistake. Anti-choicers are exploiting the tortures and deaths of women and babies in order to justify policies that will lead to more suffering, more torture, and more death. Some of them may legitimately be too stupid to see that’s what they’re doing, but by and large, I reject the notion that most of them could possibly be that dumb. All the lies being thrown around are attempts to confuse the issue, but for the sake of women and their families, we should not let the issue be confused.